بررسی میزان رعایت آیین اخلاق حرفه ای در عملکرد پرستاری از دیدگاه پرستاران، دانشجویان و بیماران
محورهای موضوعی : سلامتفروزان رستمی 1 , کلثوم اکبر نتاج بیشه 2 , آذر رمضانی توبه 3 , حمیرا اکبرزاده 4 , سمیه طالبی 5 , حوا عبدی 6
1 - استادیار، گروه پرستاری، دانشکده پرستاری و مامایی، دانشگاه آزاد اسلامی، واحد چالوس، چالوس، ایران.
2 - استادیار، گروه پرستاری، دانشکده پرستاری و مامایی، دانشگاه آزاد اسلامی، واحد ساری، ساری، ایران، Email: akbar2536@gmail.com
3 - گروه پرستاری، دانشکده پرستاری و مامایی، دانشگاه آزاد اسلامی، واحد ساری، ساری، ایران
4 - گروه پرستاری، دانشکده پرستاری و مامایی، دانشگاه آزاد اسلامی، واحد ساری، ساری، ایران
5 - گروه پرستاری، دانشکده پرستاری و مامایی، دانشگاه آزاد اسلامی، واحد ساری، ساری، ایران
6 - گروه پرستاری، دانشکده پرستاری و مامایی، دانشگاه آزاد اسلامی، واحد ساری، ساری، ایران
کلید واژه: اخلاق حرفه اي, بیماران بستري, تامین اجتماعی, دانشجویان پرستاری, کادر پرستاري, علوم پزشکی,
چکیده مقاله :
چکیده مقدمه: این پژوهش با هدف تعیین میزان رعایت آیین اخلاق حرفه ای در عملکرد پرستاری از دیدگاه پرستاران، دانشجویان و بیماران مراکز آموزشی درمانی دانشگاه علوم پزشکی و تامین اجتماعی مازندران درسال1398انجام شده است. روش پژوهش: این پژوهش توصیفی- تحلیلی از نوع مقطعی با مشارکت 299 پرستارو 287دانشجوی پرستاری به شیوه سرشماري و384 بیمار بستري با استفاده ازنمونه گیري خوشه ای در بخش هاي داخلی–جراحی و زنان بیمارستان هاي آموزشی دانشگاه علوم پزشکی و تامین اجتماعی مازندران انجام شد. داده ها با استفاده از شاخص هاي آمار توصیفی و آزمون کاي دو، همبستگی و آزمون های کروسکال والیس و من ویتنی تجزیه و تحلیل شد. یافته ها: رعایت آئین اخلاق حرفه اي از دیدگاه پرستاران و دانشجویان و بیماران درابعاد مسئولیت پذیري به ترتیب5/51 ،6/44 و 7/61 درصد، ارتقاء کیفیت مراقبت از بیمار به ترتیب1/39 ،7/78 و2/56 درصد و احترام به بیمار به ترتیب 5/59 ،2/36و2/63 درصد مطلوب بود. همچنین بین دیدگاه پرستاران، دانشجویان و بیماران در هر سه بعد تفاوت معنی داري مشاهده شد(05/0P<) و بیشترین میانگین رعایت ابعاد اخلاق حرفه ای در پرستاران مشاهده گردید. نتیجه گیری : با توجه به نتایج پژوهش آموزش و برگزاري دوره هاي بازآموزي مؤثرکادر پرستاری و نیز آموزش كدهاي اخلاق حرفه اي در واحد درسی و کارگاه مرتبط با آن به دانشجویان پرستاری با هدف بالا بردن آگاهی آنها وعملکرد و کیفیت مراقبت بهداشتی بهینه تر تاکید و پیشنهاد می گردد.
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Abstract Introduction: Observance of ethical standards in nursing work leads to the improvement of nursing services. The aim of this study was to determine the level of professional ethics in nursing practice from the perspective of nurses, students and patients of medical centers of Mazandaran University of Medical Sciences and Social Security in 2019. Research Methods: This descriptive-analytical cross-sectional study was performed with the participation of 299 nurses, 287 nursing students by census method and 384 hospitalized patients using cluster sampling in internal medicine and surgery wards of Mazandaran University of Medical Sciences and Social Security. The research instrument was a questionnaire consisting of 31 questions specific to the nursing community, 22 questions for the student community and 22 specific questions for the patient community. Data were analyzed using descriptive statistics and Chi-square, correlation and Kruskal-Wallis and Mann-Whitney tests. Results: Observance of professional ethics from the perspective of nurses, students and patients in terms of responsibility were 51.5%, 44.6% and 61.7%, respectively, improving the quality of patient care, respectively, 39.1%, 78.7% and 56.2%, respectively. Patient respect was 59.5%, 36.2% and 63.2%, respectively. Also, there was a significant difference between the perspective of nurses, students and patients in all three dimensions (P <0.05) and the highest average of professional ethics was observed in nurses. Conclusion: According to the research results, training and holding effective retraining courses for nursing staff and also teaching professional ethics codes in the course and related workshops to nursing students with the aim of raising their awareness and performance and quality of optimal health care.
1. Sadati AK, Salehzade H, Joulaei H, Hemmati S. College’s Role in Ethical Promotion of Nursing. J Health Man Info. 2014;1(1):7–10. https://jhmi.sums.ac.ir/article_42612.html
2. Grace PJ. Nursing ethics and professional responsibility in advanced practice. 3 st ed. Burlington: Jones & Bartlett. Learning; 2017: 35-68, https://philpapers.org/rec/GRANEA-2
3. Jafari H, Khaghanizade M, Nouri JM, Nir MS, Jafari H, Khaghanizade M, et al. Developmental Strategies for Nursing Ethics Education. Medical Ethics J. 2017;10(38):81–90.DOI:10.21859/mej-103881
4. Khaghanizade M, Malaki H, Abbasi M, Abbaspour A, Mohamadi E. Faculty-Related Challenges in Medical Ethics Education: A Qualitative Study. Iran J Med Edu. 2012;11(8):903–16.URL: http://ijme.mui.ac.ir/article-1-1434-en.html
5. Bijani M, Tehranineshat B, and Torabizadeh C. Nurses’, nursing students’, and nursing instructors’ perceptions of professional values: a comparative study, Nursing Ethics, 2019;26(3): 870–883.https://doi.org/10.1177/0969733017727153
6. Turale S. Technology and its impact on nursing education, Journal of Nursing Science, 2011; 29(1): 9–17. https://he02.tci-thaijo.org/index.php/ns/article/view/2792
7. Bijani M, Ghodsbin F, Fard S. J, Shirazi F, Sharif F, and Tehranineshat B. An evaluation of adherence to ethical codes among nurses and nursing students, Journal of Medical Ethics and History of Medicine, 2017; 10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5746660/
8. Rokhafrooz D, Hatami A, Hemmatipour A, Abdolahi-Shahvali E, and Kamboo M. S. “Assessing nurses’ moral distress and patients’ satisfaction with the observance of the patients’ rights charter,” Journal of Nursing and Midwifery Sciences, 2017; 4(4): 147. DOI: 10.4103/JNMS.JNMS_1_18
9. Sanjari M, Zahedi F, and Larijani B. Ethical codes of nursing and the practical necessity in Iran, Journal of Medical Ethics and History of Medicine, 2008; 37(1): 22–27. https://ijph.tums.ac.ir/index.php/ijph/article/view/2886
10. Hariharan S, Jonnalagadda R, Walrond E, and Moseley H. Knowledge, attitudes and practice of healthcare ethics and law among doctors and nurses in Barbados, BMC Medical Ethics, 2006; 7(1): 7. DOI: 10.1186/1472-6939-7-7
11. Tehranineshat B, Rakhshan M, Torabizadeh C, and Fararouei M. Nurses’, patients’, and family caregivers’ perceptions of compassionate nursing care, Nursing Ethics, 2019; 26(6): 1707–1720. https://doi.org/10.1177/0969733018777884
12. Tehranineshat B, Rakhshan M, Torabizadeh C, and Fararouei M. Compassionate care in healthcare systems: a systematic review, Journal of the National Medical Association, 2019; 111(5): 546–554. https://doi.org/10.1016/j.jnma.2019.04.002
13. Heydari A, Meshkinyazd A. Ethical challenges in nursing, Journal of Clinical Nursing and Midwifery, 2018; 7(1): 84–95.URL: http://78.39.35.47/article-1-747-en.html
14. Osingada C. P, Nalwadda G, Ngabirano T, Wakida J, Sewankambo N, and Nakanjako D. Nurses’ knowledge in ethics and their perceptions regarding continuing ethics education: a cross-sectional survey among nurses at three referral hospitals in Uganda, BMC Research Notes, 2015; 8(1): 319. D.o.i:/10.1186/s13104-015-1294-6
15. Momennasab Koshkaki A.R, Torabizadeh C, and Tabei S. Z. “Nurses’ adherence to ethical codes,” Nursing Ethics, 2016; 23(7): 794–803. DOI: 10.1177/0969733015583927
16. Mahdavi L. Z, Ghaedi H. F. The comparison of observing the ethical codes among nursing students and nursing practitioners in Al-Zahra hospital in Isfahan, Journal of Medical Education Development, 2012; 7(3):5. doi:10.1155/2020/5749687
17. Torabizadeh C, Ebrahimi H, Mohammadi E, and Valizadeh S. Incongruent perceptions among nurses and patients: a qualitative study of patient’s dignity in Iran, Ethics & Behavior, 2013; 23(6): 489–500. https://doi.org/10.1080/10508422.2013.793162
18. Eilts-Köchling K, Heinze C, Schattner P, Voß M, and Dassen T. Knowledge of professional codes of ethics among nursing professionals,” Pflege, 2000; 13(1): 42–46 https://doi.org/10.1024/1012-5302.13.1.42
19. Goethals S, Gastmans C, and de Casterlé B. D, Nurses’ ethical reasoning and behavior: a literature review, International Journal of Nursing Studies, 2010; 47(50): 635–650. https://doi.org/10.1016/j.ijnurstu.2009.12.010
20. Khaghanizadeh M, Maleki H, Abbasi M, Abbaspour A, and Mohamadi E. Related challenges in medical ethics education: a qualitative study, Iranian Journal of Medical Ethics Education, 2012; 11(7): 903–916. http://ijme.mui.ac.ir/article-1-1434-en.html
21. Zali A. Bioethics teaching, Medical Ethics Journal, 2016; 1(1): 16. http://doi.org/10.22037/bhl.v1i1.38125
22. Cannaerts N, Gastmans C, and Casterlé B. D. d. Contribution of ethics education to the ethical competence of nursing students, Nursing Ethics, 2014; 21(8): 861–878. https://doi.org/10.1177/0969733014523166
23. Namadi F, Hemmati-Maslakpak M, Moradi Y, and Ghasemzadeh N. The effects of nursing ethics education through case-based learning on moral reasoning among nursing students, Nursing and Midwifery Studies, 2019; 8(2): 85–90. DOI:10.4103/nms.nms_33_18
24. Chao S.-Y, Chang Y.-C, Yang S. C, and Clark M. J. Development, implementation, and effects of an integrated web-based teaching model in a nursing ethics course, Nurse Education Today, 2017; 55: 31–37. DOI: 10.1016/j.nedt.2017.04.011
25. Dehghani A, Radbeh F, Parviniannasab A M, Khaki S, Shamsizadeh M, Beyramijam M. Enactment of Professional Ethics Standards Compliance in Patients and Nurses Prospective. J Holist Nurs Midwifery, 2015; 25 (4): 64-72. http://hnmj.gums.ac.ir/article-1-580-en.html
26. Jollaei S. Bakhshande B, Mohmmad Ebrahim M, Asagharzade M, Vasheghani Farahani A, Shareiat E, et al. Nursing Ethics codcs in Iran: Report of a qualitative study. Journl of Medical Ethics and History of Medicine, 2010; 3(2): 46- 52. DOI:10.29252/jhc.22.1.75
27. Mohajjel Aghdam A, Hassankhani H, Zamanzadeh V, Khameneh S, Moghaddam S. Nurses' Performance on Iranian Nursing Code of Ethics from Patients' Perspective. IJN 2013; 26 (84) :1-11. DOI: 10.5681/jcs.2013.027
28. McCrink A. Nursing student attitudes towards academic misconduct, the code of ethics for Nurses and their commitment to the ethic of caring: ProQuest, 2008. DOI:10.3928/01484834-20100831-03
29. Shannon SE, Mitchell PH. Cian KC. Patients, Nurses, and physicians have differing views of quality of critical care, Journal of Nursing Scholarship. 2002; 34: 173-179. Doi: 10.1111/j.1547-5069.2002.00173. x.
30. Jafari manesh H, Ranjbaran M, Vakilian K, Tajik R, Almasi-Hashiani A. Nursing’s code of ethics: a survey of respecting the code among nursing students. ijme 2014; 6 (6): 45-55 http://ijme.tums.ac.ir/article-1-5263-en.htmlv
31. Kohan N, Sabzevari S, Nakhaei N, Kohan M. The Evaluating of patients perspective in medical and surgical wards of Kerman university of medical science hospitals than individual privacy compliance. Journal of Kerman Nursing and Midwifery school. 2007; 7, 40-47. http://koomeshjournal.semums.ac.ir/article-1-1093-en.html
32. Dadkhah B, Mohammadi MA. Taghavi N. The Respect to territory and rights of patients in hospitals in Ardabil. Iranian Journal of Nursing & Midwifery Research, 2005; 23: 37- 44. http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/174
33. Jormsari P, Kunavicticul W, Ketefian Sh, Chaowalit A. Moral competencc in nrsing, practice. Nurs Ethics. 2005; 12(6):582 593. Doi:10.1191/0969733005ne828oa
34. Esmaeilpourzanjani S, Mashouf S, khaki S. Evaluation of Professional Ethics Observance in Nursing Practice from Nurses and Patients’ Point of View in Shahid Beheshti University of Medical Sciences’ Teaching Hospitals. Iranian Journal of Medical Education 2015; 15:447-459. http://ijme.mui.ac.ir/article-1-3776-en.html
35. Wehrwein T. Moral reasoning and ethics Decision-making in Beginning Baccalaureate students [dissertation]. United states, Michigan state university, 1990.